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Rheology of the Newborn and their Disorders
Published in Gordon D. O. Lowe, Clinical Blood Rheology, 2019
Symptoms may indicate the involvement of more than one system at a time, though there is usually one which predominates. In those infants with hematocrits above 0.70, for example, the pulmonary vascular resistance and pressure are elevated sufficiently to produce respiratory symptoms and the clinical appearance of persistent fetal circulation. Likewise cerebral blood flow veolcity46 and renal blood flow47 are measurably reduced in states of hyperviscosity, with the expected accompanying clinical consequences and improvement following hemodilution.
Congenital diaphragmatic hernia
Published in Prem Puri, Newborn Surgery, 2017
Postoperative care should be performed in the same manner as preoperatively, with a close watch on fluid management, ventilator, support and hemodynamic monitoring.77 Some infants show improvement in oxygenation in the honeymoon period but usually deteriorate 6–24 hours later. This deterioration is due to pulmonary hypertension and persistent fetal circulation with an increase in pulmonary artery resistance, elevated pulmonary artery pressure, and right-to-left ductal and preductal shunting, leading to hypoxemia. Pulmonary hypertension is probably caused by multiple factors, such as increased abdominal pressure with impaired visceral and peripheral perfusion, limited diaphragmatic excursion, overdistension of the alveoli in the hypoplastic lungs with diminished alveolar-capillary blood flow, release of vasoactive cytokines, and deterioration in pulmonary compliance after surgical repair. Sudden deterioration in the patient’s oxygenation status should raise the suspicion of pneumothorax. Infection complications including pneumonia and septicemia are not uncommon.
Normal fetal development and growth
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
Occasionally, this transition from fetal to adult circulation is delayed, usually because the pulmonary vascular resistance fails to fall despite adequate breathing. This delay, termed persistent fetal circulation, results in left-to-right shunting of blood from the aorta through the ductus arteriosus to the lungs. The baby remains cyanosed and can suffer from life-threatening hypoxia. This delay in closure of the ductus arteriosus is most commonly seen in infants born preterm (<37 weeks’ gestation). It results in congestion in the pulmonary circulation and a reduction in blood flow to the gastrointestinal tract and brain, and is implicated in the pathogenesis of necrotizing enterocolitis and intraventricular haemorrhage, both of which are complications associated with preterm birth.
An update on medication management of women with schizophrenia in pregnancy
Published in Expert Opinion on Pharmacotherapy, 2019
Carolyn Breadon, Jayashri Kulkarni
Babies of mothers with schizophrenia have been found to have lower APGARs at 5 minutes, higher rates of respiratory depression and intubation, higher rates of neonatal abstinence syndrome, seizures, intraventricular hemorrhage and persistent fetal circulation [1,14]. However, when compared with closely matched controls, rates of seizures, intraventricular hemorrhage and persistent fetal circulation approach parity [16,18]. Socioeconomic disadvantage as a corollary of major mental illness is a consistent finding across much research [19]. In this context, it appears that socioeconomic disadvantage associated with mental illness confers a high risk of adverse outcomes for both mother and baby at delivery.